Modeling the Impact of COVID-19 Vaccination in Lebanon: A Call to Speed-Up Vaccine Roll Out.

Four months into the SARS-CoV-2 vaccination campaign, only 10.7% of the Lebanese population have received at least one dose, raising serious concerns over the speed of vaccine roll-out and its impact in the event of a future surge. Using mathematical modeling, we assessed the short-term impact of various vaccine roll-out scenarios on SARS-CoV-2 epidemic course in Lebanon. At current population immunity levels, estimated by the model at 40% on 15 April 2021, a large epidemic wave is predicted if all social distancing restrictions are gradually eased and variants of concern are introduced. Reaching 80% vaccine coverage by the end of 2021 will flatten the epidemic curve and will result in a 37% and 34% decrease in the peak daily numbers of severe/critical disease cases and deaths, respectively; while reaching intermediate coverage of 40% will result in only a 10-11% decrease in each. Reaching 80% vaccine coverage by August would prevent twice as many severe/critical disease cases and deaths than if it were reached by December. Easing restrictions over a longer duration resulted in more favorable vaccination impact. In conclusion, for vaccination to have impact in the short-term, scale-up has to be rapid and reach high coverage (at least 70%), while sustaining social distancing measures during roll-out. At current vaccination pace, this is unlikely to be achieved. Concerted efforts need to be made to overcome local challenges and substantially scale up vaccination to avoid a surge that the country, with its multiple crises and limited health-care capacity, is largely unprepared for.